PUD Flashcards by Kol Giessel

Classes of drugs to treat PUD (5)

Antibiotics for H.Pylori
Anti Secretory:
Mucosal Protectant:
Prostaglandin Agent
Antacid

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3 ways drugs work to treat ulcers

erradicate H pylori
reduce gastric acidity
enhance mucosal defenses

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Anti ulcer drugs only treat ulcers: true or false

FALSE- also treat gastritis and GERD

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What is the regiment for treating H pylori w/ ABX ? how long?

At least 2 antibiotics, preferably 3 abx + PPI or H2 blocker
->14 days

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do we give ABX to someone who is asxs but has h pylori ?

nope!

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issues w/ treating h pylori?

patient complianc: cost, pill count, SE

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3 types of anti secretory agents:

H2Blockers
Proton Pump Inhibitors
Muscarinic antagonist ???

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prototype of H2 blockers

Prototype: cimetidine (Tagamet) –> in the drug book, original H2 blocker
Also Know: famotidine (Pepcid) –> more commonly used

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how fo H2 blockers work?

Act on H2 receptors on parietal cells

- ->Suppress acid secretion

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indication for using H2 blockers

ulcers, GERD, heartburn, aspiration pneumonitis, Zollinger-Ellison syndrome (acid hypersecretion)

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Duration of treatment on H2 blockers

4-6 weeks, up to 12

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side effects of cimetidine

LOW
◦ Androgen blockade :Gynecomastia, reduced libido, impotence
◦ CNS Effects b/c crosses BB : Elderly (somnolence, seizure)
◦ Pneumonia (all H2 blockers)
‣ Bacterial colonization in the stomach increases with less acid present
• increase risk of aspiration pneumonia

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drug drug interactions w/ cimetidine

◦ Warfarin, phenytoin, metformin, glipizide

◦ separate antacids by 1 hr.

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route for cimetidine

IV, oral 2x day

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side effects of famotidine?

pneumonia risk

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prototype for anti secretory: proton pump inhibitor

omeprazole (Prilosec)

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how does omeprazole (Prilosec) fxn

Irreversible inhibition of H+,K+ ATPase

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most effective drug for acid suppresiion?

omeprazole (Prilosec)

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how long does omeprazole (Prilosec) work and when do see effects?

-life of enzyme (1 day) and results w/in 2 hours

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indication for using omeprazole (Prilosec)

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ulcers, erosive esophagitis, GERD Zollinger-Ellison, stress ulcer prevention–> ICU/Trauma

how long to be on omeprazole (Prilosec)

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4-8 weeks

short term vs long term side efffects of omeprazole (Prilosec)

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Side Effects: headache, diarrhea, N/V (<1%)
long term side effects: osteoporosis and hip fractures, Cdiff, pneumonia, acid rebound (difficult to come off drug), kidney disease, Mg deficiency
◦ Possible: B12 deficiency, dementia

patient education for omeprazole (Prilosec)

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• only want patients on these short term!

–> wean off and put on H2 blocker

ending for ppi’s

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prazole

prototype for mucosal protectant

Sucralfate

how does Sucralfate fxn

Creates a protective coating on the gastric and esophageal surface -->protects the ulcer from acid and pepsin *Not absorbed -> does not reduce acid secretion

side effects of Sucralfate

constipation

admin for Sucralfate

Take 1 hr before meals and at HS >Interfere with absorption of other meds • Separate by 2 hrs.

admin considerations giving sucralfate for gi vs esophagus ulcer

- Ulcers in esophagus: make a slurry w/ the pill | - Ulcers in stomach: take pill as regular

Prostaglandin Agent prototype

misoprostol (Cytotec)

how does misoprostol (Cytotec) fxn?

Synthetic prostaglandins (stimulate secretion of mucous/bicarbonate, cause vasodilation

how do NSAID cause ulceration?

NSAID inhibits prostaglandin --> suppresses mucous/bicarb, promote gastric acid

indication for using misoprostol (Cytotec)

Used only for NSAID gastric ulcers

misoprostol (Cytotec) safe for preggos?

Pregnancy Category X --> prostaglandins stimulate uterine contractions

side effects of misoprostol (Cytotec)

diarrhea, abdominal pain, spotting, dysmenorrhea

fxn of antacids

Alkaline compounds that neutralize stomach acid

indication for using antacids

PUD, GERD symptom control

admin of antacids

Separate 1 hour from other drugs --> drug needing acidic enviro for absorb will be diminished

different kinds of antacid compounds

aluminum magnesium calcium sodium

antacid compounds that cause constipation?

aluminum | calcium

anatacid compound not safe for renal disease?

magnesium

magnesium + kidney disease = hypo or hyper magnesium?

hyper

antacid of choice? why?

milk of magnesia is antacid of choice: high acid neutralizing effects, rapid acting, long lasting effects

antacid compound that causes diarrhea

magnesium

antacid compound that causes gas

sodium and calcium

anatacid compound that causes fluid retention

sodium

avoid sodium antacids in which patient popilation

HTN, heart failure

antacid compound that causes acid rebound and need repeat dosing

calcium (tums)

what is simethicone

decreases gas (not a PUD or laxative)

PUD Flashcards

(49 cards)